Cetrotide — CareFirst (Caremark)
Inhibition of premature luteinizing hormone (LH) surges in women undergoing controlled ovarian hyperstimulation or controlled ovarian stimulation
Initial criteria
- Member is undergoing ovulation induction or assisted reproductive technology (ART) for the inhibition of premature LH surges
Reauthorization criteria
- Member must continue to meet the requirements in the coverage criteria section
Approval duration
12 months